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Abstract: The child presented with symptoms such as high fever and ear pain, but no other uncomfortable symptoms, and was diagnosed with otitis media after examination, probably due to a bacterial infection caused by the child’s cold and flu. After systematic treatment, the child’s body temperature returned to normal and the pain symptoms were relieved, with a more satisfactory treatment effect and a better prognosis for the condition.
Basic information】Female, 1 year old
Disease Type】Otitis media
Hospital】The First Affiliated Hospital of Xi’an Jiaotong University
Date of Consultation】March 2021
Treatment plan】Oral medication (cefuroxime dry suspension, ibuprofen suspension) + ear drops (levofloxacin hydrochloride ear drops)
Treatment period】6 days in hospital, 1 week later outpatient review
Treatment effect] The child’s body temperature returned to normal and the ear pain was relieved.
I. Initial interview
When the child was first seen, he was irritable, crying, and red in color. The parents described that the child had developed a high fever, which could reach 39℃, after getting a cold 2 days ago, and was accompanied by pain in the left ear. On examination, the child was found to have bilateral symmetrical auricles, no deformity, no laceration, no redness, swelling and pulling pain, but the left tympanic membrane was congested, and otitis media was suspected, and hospitalization was recommended for further examination, to which the family agreed. After admission, the child’s ultrasensitive C-reactive protein was measured, and the results indicated that Hs-CRP was 108.49 mg/L. Routine blood tests were performed, and the results indicated that WBC 13.2×10^9/L, HGB 114.0 g/L, MCH 26.9 pg, MCHC 314 g/L, P-LCR 17.0%, NEUT 9.11×10^9/L, and MONO1.11×10^9/L, which was initially diagnosed as acute otitis media.
II. Treatment history
After the diagnosis of otitis media was confirmed, I informed the child’s family that medication could be used to fight the infection, followed by symptomatic medication to relieve the child’s fever as well as the ear pain, and the family agreed. The child was given cefuroxime dry suspension to fight the infection, along with ibuprofen suspension to relieve the pain and fever. In addition, the parents were asked to give the child ear drops with levofloxacin hydrochloride to further relieve the inflammation of the child’s ear.
III. Treatment effect
The child’s ear pain symptoms and fever improved after systematic medication. On the third day of treatment, the child’s body temperature returned to normal and there was no fever. The child’s ear pain was relieved and he did not cry anymore, but only occasionally complained of ear pain. On the 6th day of treatment, the child’s ear pain disappeared completely, and the routine blood test showed that the white blood cells were normal again, indicating that the treatment effect was satisfactory, and there was no recurrence after stopping the drug.
IV. Precautions
I was very happy to see the child’s symptoms relieved and his body recovered after medication, and a smile appeared on his tender face.
1. The child’s external ear canal should be kept clean on a daily basis to avoid water or foreign bodies, which may lead to bacterial growth and thus cause recurrence of otitis media.
2. Families should help their children blow their noses normally to prevent nasal secretions from entering the middle ear through the eustachian tube and causing infection.
3. They should also keep the air in the room clean to avoid stimulating the respiratory mucosa of the child with unclean gas, which may aggravate the symptoms.
4. In terms of diet, we should also pay attention to balanced nutrition and eat meat, eggs, vegetables, fruits, etc., and avoid eating spicy and greasy food.
V. Personal insight
Otitis media mainly occurs after a cold or flu and is caused by bacterial infections such as Streptococcus pneumoniae and Staphylococcus aureus, and is more common in children, with ear pain as the main symptom. The parents of the 1-year-old baby girl in this case did not take her to the doctor in time after the symptoms appeared, but gave cold medicine on their own, resulting in recurring symptoms, but it is good that the condition is relatively mild, and the condition is relieved by medication, otherwise continued delay in treatment may lead to aggravation of the condition, and may even lead to hearing loss and intracranial complications in the affected child.